Healthcare Provider Details

I. General information

NPI: 1003278482
Provider Name (Legal Business Name): MORGAN BOWLING D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 1ST AVE
NEW YORK NY
10003-2925
US

IV. Provider business mailing address

201 LYONS AVE
NEWARK NJ
07112-2027
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MB10546800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MB10546800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number314969-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: